Setting the stage for successful ageing

SMU Professor Paulin Straughan, Director or ROSA, shared key research findings from the Centre's ongoing Singapore Life Panel (SLP) and how these findings support Singapore's 'Healthier SG' approach. 

By Jill Arul

SMU Office of Research & Tech Transfer – Imagine reclining by the pool as the sun sets or spending your days in the garden tending to a thriving patch of herbs – many of us dream of an idyllic retirement without considering the groundwork that needs to be done to ensure ‘successful ageing’. To truly enjoy the later years of life, it helps to be free of disability or disease, have high cognitive and physical abilities and maintain valuable social connections.

At the Singapore Management University’s (SMU) Centre for Research on Successful Ageing (ROSA), researchers across psychology, economics, sociology and more work to define and advance the well-being among older adults to guide Singapore’s ageing population.

On 1 November 2022, at the second ROSA Annual Symposium on Successful Ageing, representatives from academia, government and non-profit organisations came together to share their findings and advance the conversation on ageing in the region.

The COVID-19 Context

The first presentation of the morning saw Associate Professor Ding Yew Yoong, executive director of the Geriatric Education and Research Institute (GERI), sharing his work on healthy ageing in the midst of COVID-19.

Professor Ding explained that maintaining functional ability is paramount to healthy ageing – where older adults are capable of meeting basic needs, learning and making decisions, moving around comfortably, and maintaining relationships. Interestingly, functional ability is influenced by both intrinsic capacity like an individual’s physical and mental capacity as well as extrinsic influences like the environment and community.

“This concept of environment encompasses promoting behaviours that build up capacity while removing barriers that make a person less able to overcome their loss of capacity,” shared Professor Ding. “It is important to note that intrinsic capacity and the environment interact to influence functional ability. A person’s intrinsic capacity is what they have, but with a good environment their capacity can improve.”

To maintain intrinsic capacity, Professor Ding shared that older adults can participate in preventative measures like regular physical activity for locomotor ability, social interaction for cognition and peer support for psychological health.

However, it is also important for their environment to support their needs. For example, their social relationships can be nurtured by providing community spaces to interact with peers while their locomotor abilities can be maintained with regular visits to the doctor. In the midst of COVID-19, the environment and available support plays a particularly important role as community spaces transform into online communication and health services begin to offer virtual visits.

“If you want to promote healthy ageing in this COVID-19 era, it really requires a whole-of-society approach that incorporates preventative efforts that target both intrinsic capacity and extrinsic environment because we know both have an effect on the functional ability and well-being of older people,” said Professor Ding.

Building a Healthier SG

Emphasising the importance of a whole-of-society approach, Professor Paulin Straughan, Director of ROSA, shared key findings from the Centre’s ongoing Singapore Life Panel (SLP) and explained Singapore’s ‘Healthier SG’ approach.

Launched in August 2015 by the Centre for Research on the Economics of Ageing (CREA), the SLP is a large-scale monthly survey that gathers data from 8,149 individuals aged 57 to 76 in 2022. With ROSA at the helm since 2020, the SLP will be refreshed to gather data from a wider sample and serve a broader research focus.

One important finding from the SLP points toward the importance of having a regular family doctor. The surveys indicate a trend where respondents with a regular doctor are more likely to agree that regular health check-ups are important.

“We hypothesise that the mental barrier is broken,” shared Professor Straughan. “If you have a regular doctor, it’s a no brainer because you are reminded to go for your regular appointments. Interestingly, those who are younger among the SLP needed a bit more encouragement to go for preventative health checks.”

The findings from the SLP support Singapore’s plans to encourage successful ageing through Healthier SG – an ecosystem of health groups and government agencies that aim to maintain the well-being of Singaporeans. Leveraging the importance of a regular family doctor, Healthier SG has set up nationally recommended health screenings and vaccinations where family doctors are mobilised to provide preventative care to individuals.

To ensure everyone has access to health and social resources, the Healthier SG plan also includes infrastructure advancements that will set up enablers like IT, financing policy and manpower development. “The government is committed to improving enablers – whatever we need in the build environment,” explained Professor Straughan.

The symposium also included short sessions where each table could discuss and share their thoughts on the presentation with a prompt. In response to potential obstacles to the Healthier SG movement, many attendees felt awareness and education are important factors to address as well as ensuring access to individuals from lower-income families.

Ageing in Asia

After a quick break, the morning session continued with four presentations from researchers in the region. Presenting a paper titled, How do health shocks affect health and labour market dynamics, and the socioeconomic-health gradient in older persons, SMU Associate Professor Seonghoon Kim shed light on trends between labour and well-being of older adults.

SMU Associate Professor Seonghoon Kim sharing on the trends between labour and well-being of older adults during the presentation of his paper.

With 60 monthly waves of longitudinal data from the SLP, Professor Kim and his team assessed how health shapes the socioeconomic status of an individual as well as their work activity. While recovery does not vary significantly after the diagnosis of a major health shock, individuals with low socioeconomic status were found to be less likely to be employed following ill health. Interestingly, Professor Kim pointed out that in many countries the health gap lessens between socioeconomic groups over time after retirement, while in Singapore it remains relatively parallel.

“The reason why we see a smaller gap at older ages in other countries is because those in lower socio-economic groups continue to get better after retirement,” he explained. “In Singapore, we observed that low socio-economic groups work significantly more than high socio-economic groups do at older ages, while the opposite is true when they were young. This suggests that there are a significant portion of people who are delaying their retirement because they are not yet prepared for retirement. Strengthening social insurance and welfare programs can be an effective approach in reducing unwanted employment at older ages to reduce the health gap."

Similarly exploring work culture and activity, Professor Takashi Oshio from the Economic Research Institute at Hitotsubashi University in Japan assessed the health capacity to work among older Japanese adults. In a later presentation, Associate Professor Fang Zheng from the Singapore University of Social Sciences explained the importance of lifelong learning.

ROSA scholar, Mr Jonathan Chia, presenting on his research on the profiles of social activity and depression trajectories among older adults.

Finally, addressing the current climate of relaxed COVID-19 restrictions, Mr Jonathan Chia, ROSA scholar, presented his research titled Profiles of Social Activity and Depression Trajectories as COVID-19 Restrictions are Relaxed. Mr Chia's work identified predominant profiles of social activity among older adults, ranging from high physical and outside activity to broadly inactive. Across the profiles, Mr Chia found that older adults who utilised digital technologies more frequently showed lower baseline depression. Drawing from the results of his research as well as broader literature, Mr Chia suggested that digital contact can increase resilience among older adults, particularly through trying times like the COVID-19 pandemic.

In light of the work shared, the second annual ROSA symposium has made it clear that with robust research and collective social action, academia, government and community players can come together to ensure the well-being of Singapore’s older adults.

Back to Research@SMU November 2022 Issue